The Nevada Governor’s Office of Economic Development (GOED)
has rewarded the University of Nevada Las Vegas School of Nursing with a
$900,000 grant. UNLV will put the grant toward expanding new advanced training
opportunities and continuing education for nurses.
UNLV received the grant to develop nursing certificates designed
to meet specific needs around the state, such as teaching, specialty care, and
clinical research.
The grant support, which originated from the GOED’s Workforce Innovations for a New Nevada program, is a continuation of UNLV’s plans in recent years to work on solving the state’s continually evolving medical needs. The UNLV School of Nursing has seen an admission increase of 50 percent since fall 2017 for BSN candidates. The school also has one of the top-ranked online master’s degree programs, and is also home to the Clinical Simulation Center of Las Vegas (CSCLV). The CSCLV, a technologically advanced educational facility, provides nursing and medical students opportunities to practice their skills through various simulations.
“At the UNLV School of Nursing, we educate nurses to provide the highest quality care for the citizens of Nevada,” Amar said. “The developing Las Vegas medical district and UNLV medical school make it important that nursing grows also. The increase in enrollment furthers our ability to meet the health care needs of our diverse population. With a critical need for highly trained nurses across our region and state, expanding our BSN class sizes will increase the number of graduates who can meet this demand.”
The planned certificate programs, which include Certified
Nursing Assistant Instructors, Clinical Research Administrators, and Health
Information Technology and Data Analytics, were developed in partnership with several
health care organizations across the state, such as University Medical Center
of Southern Nevada, and Comprehensive Cancer Centers of Nevada. These partners
will help with job placement for all certification program participants.
The Valley Health System, University Medical Center of
Southern Nevada, Comprehensive Cancer Centers of Nevada, and the Kenny Guinn
Center for Policy Priorities. Health care employer partners, along with
projected industry growth, will ensure successful placement of participants following
their completion of the various programs, to ensure these nurses provide the
best possible care to Nevada patients.
Last year the Centers for Medicare & Medicaid Services (CMS) reined in its mandatory bundled payment models, leaving many healthcare providers concerned that investments they made to prepare for these models might for naught.
But those investments in value-based care models may not go wasted after all under CMS’ new voluntary Bundled Payments for Care Improvement (BPCI) Advanced model.
Participants in the new model will be expected to keep Medicare expenditures within a defined budget, while maintaining or improving performance on these seven specific quality measures:
All-cause hospital re-admissions
Advanced care plan
Perioperative care: Selection of prophylactic antibiotic (first or second generation cephalosporin)
Hospital-level risk-standardized complication rate following elective primary total hip arthroplasty and/or total knee arthroplasty
Hospital 30-day, all-cause, risk-standardized mortality rate following coronary artery bypass graft surgery
Excess days in acute care after hospitalization for acute myocardial infarction
Agency for Healthcare Research and Quality patient safety indicators
CMS is changing its formula for calculating and allocating funds for uncompensated care for hospitals that qualify under its Disproportionate Share Hospital program. This new method presents both opportunities and challenges for organizations.
Thanks to the changes, hospitals may be able to identify care currently written off without a determination of financial need. Additionally, the new methodology for calculation of Factor 3 — a hospital-specific factor representing its share of the total uncompensated care provided — may allow hospitals to capture a larger portion of uncompensated care funds.
However, leaders should be aware that CMS is phasing in the use of cost report Worksheet S-10 data, including charity care and unreimbursed bad debt. This year, one-third of Factor 3 will be based on this data, but by fiscal year 2020, use of this data will be fully implemented.
To ensure compliance with reporting data on Worksheet S-10, leaders need to review new guidance from CMS as well as their own organizational policies for charity care determinations, uninsured patient discounts, and bad debt collections. Training for staff involved with submission of the cost report and handling charity care write-off is imperative.
One concern consistently raised about the implementation of pay-for-performance models is that healthcare providers and organizations serving more complex patients would not reap the same rewards as hospitals caring for less sick patients.
New research suggests that those fears may be warranted. A November 2017 study found that Medicare’s Value-based Payment Modifier program inadvertently shifted money away from physicians who treated sicker, poorer patients to pay for bonuses that rewarded practices treating richer, healthier populations.
The study’s lead author Eric Roberts, PhD, of the University of Pittsburgh Graduate School of Public Health, said that if changes aren’t made, value-based payment models will continue to foster this inequity.
“Risk adjustment is usually inadequate in these programs, in part, because it is difficult to measure the differences in complexity of patients across providers. We need to take a careful look at how incentives in these programs are structured and how performance is assessed in order to create the right incentives to improve value and outcomes for the most vulnerable patients,” Roberts said.
The grant was announced by Senator Jerry Moran (R.-Kansas) who lauded PSU for its commitment to equipping healthcare professionals to care for victims of sexual assault. He tells MorningSun.net, “This place is a role model for Kansans. The school’s ability to bring federal grant dollars back to Kansas is extremely valuable, and the grants announced today will empower nurses to advance their education and place an emphasis on serving communities in need of their skills.”
SANE nurses are registered nurses who have completed specialized education in medical forensic care of patients who have experienced sexual abuse. There is currently only one SANE nurse serving Crawford County. PSU alum Wendy Overstreet will use her expertise to serve as coordinator for the SANE Program at PSU.
Overstreet has limited her care to pediatric patients because she is the only SANE nurse in the area. Adults over the age of 17 are sent to other counties, and sometimes other states to be examined, which can come at great personal and financial cost. She hopes that having more SANE nurses will help keep victims in the county and lead to an increase in incident report and follow through on prosecution. The university hopes to eventually expand sexual assault nurse examiner access to eight surrounding counties.
To learn more about Pittsburg State University’s $800,000 grant to fund sexual assault nurse training, visit here.
